PMID- 26519895
OWN - NLM
STAT- MEDLINE
DCOM- 20160912
LR  - 20220321
IS  - 1872-6968 (Electronic)
IS  - 0303-8467 (Linking)
VI  - 139
DP  - 2015 Dec
TI  - Prediction of quality of life improvements in patients with lumbar stenosis 
      following use of membrane stabilizing agents.
PG  - 234-40
LID - S0303-8467(15)30049-4 [pii]
LID - 10.1016/j.clineuro.2015.10.018 [doi]
AB  - OBJECTIVE: Membrane stabilizing agents (MSAs) improves function and reduces 
      neuropathic pain in a subset of patients with LSS. No study has investigated the 
      pre-treatment demographic and psychosocial factors associated with quality of 
      life (QOL) outcomes following the use of MSAs. In this study we sought to create 
      prediction models for post-treatment outcome. METHODS: All patients who were 
      diagnosed with LSS and treated with MSAs at a single institution between 
      September 2010 and March 2013 were retrospectively reviewed. QOL outcomes were 
      collected prospectively. Prediction tools were created using multivariable 
      logistic regression and Cox proportional hazard models. Outcome measures were: 1 
      - need for surgery within 1 year after initiating MSA treatment, 2 - time until 
      surgery after initiating MSA treatment, 3 - any improvement in EuroQol (EQ)-5D 
      QOL index, 4 - improvement in EQ-5D index exceeding the minimum clinically 
      important difference (MCID). RESULTS: 1346 patients were included. For goal 1 
      (need for surgery), the prediction model was less robust. For goal 2 (time to 
      surgery), only age was a significant predictor, with each 10-year increase in age 
      causing the hazard of eventually having surgery to increase by 20%. 382 patients 
      were available for analysis for goals 3 and 4 (predicting improvement in EQ-5D). 
      Prediction models for these goals were good with C-statistics 0.73 and 0.85, 
      respectively. Predictive factors for superior outcomes included lower baseline 
      EQ-5D index (worse QOL), less baseline depression, greater median income, and 
      being married. CONCLUSION: MSA treatment provides improvements in quality of life 
      for those individuals with LSS. Treatment effects of MSAs will be greatest in 
      those with worse quality of life, less depression, married patients, and those of 
      higher socio-economic status.
CI  - Copyright (c) 2015 Elsevier B.V. All rights reserved.
FAU - Lubelski, Daniel
AU  - Lubelski D
AD  - Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Thompson, Nicolas R
AU  - Thompson NR
AD  - Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA; 
      Neurological Institute Center for Outcomes Research and Evaluation, Cleveland 
      Clinic, Cleveland, OH, USA.
FAU - Agrawal, Basheal
AU  - Agrawal B
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 
      Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
FAU - Abdullah, Kalil G
AU  - Abdullah KG
AD  - Department of Neurological Surgery, Hospital of the University of Pennsylvania, 
      Philadelphia, PA, USA.
FAU - Alvin, Matthew D
AU  - Alvin MD
AD  - Case Western Reserve University School of Medicine, Cleveland, OH, USA.
FAU - Khalaf, Tagreed
AU  - Khalaf T
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 
      Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
FAU - Mazanec, Daniel J
AU  - Mazanec DJ
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 
      Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
FAU - Benzel, Edward C
AU  - Benzel EC
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 
      Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
FAU - Mroz, Thomas E
AU  - Mroz TE
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 
      Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
FAU - Krishnaney, Ajit A
AU  - Krishnaney AA
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 
      Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA. Electronic 
      address: krishna@ccf.org.
LA  - eng
PT  - Journal Article
DEP - 20151019
PL  - Netherlands
TA  - Clin Neurol Neurosurg
JT  - Clinical neurology and neurosurgery
JID - 7502039
RN  - 0 (Amines)
RN  - 0 (Calcium Channel Blockers)
RN  - 0 (Cyclohexanecarboxylic Acids)
RN  - 55JG375S6M (Pregabalin)
RN  - 56-12-2 (gamma-Aminobutyric Acid)
RN  - 6CW7F3G59X (Gabapentin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Amines/*therapeutic use
MH  - Calcium Channel Blockers/*therapeutic use
MH  - Comorbidity
MH  - Cyclohexanecarboxylic Acids/*therapeutic use
MH  - Decision Support Techniques
MH  - Decompression, Surgical/*statistics & numerical data
MH  - Depression/epidemiology
MH  - Female
MH  - Gabapentin
MH  - Humans
MH  - Income
MH  - *Lumbar Vertebrae
MH  - Male
MH  - Marital Status
MH  - Middle Aged
MH  - Nomograms
MH  - Pregabalin/*therapeutic use
MH  - Proportional Hazards Models
MH  - *Quality of Life
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Spinal Stenosis/*drug therapy/epidemiology
MH  - gamma-Aminobutyric Acid/*therapeutic use
OTO - NOTNLM
OT  - EQ-5D
OT  - Lyrica
OT  - Membrane stabilizing agents
OT  - Neurontin
OT  - Nomogram
OT  - Prediction
OT  - Quality of Life
EDAT- 2015/11/01 06:00
MHDA- 2016/09/13 06:00
CRDT- 2015/11/01 06:00
PHST- 2015/08/11 00:00 [received]
PHST- 2015/10/09 00:00 [revised]
PHST- 2015/10/13 00:00 [accepted]
PHST- 2015/11/01 06:00 [entrez]
PHST- 2015/11/01 06:00 [pubmed]
PHST- 2016/09/13 06:00 [medline]
AID - S0303-8467(15)30049-4 [pii]
AID - 10.1016/j.clineuro.2015.10.018 [doi]
PST - ppublish
SO  - Clin Neurol Neurosurg. 2015 Dec;139:234-40. doi: 10.1016/j.clineuro.2015.10.018. 
      Epub 2015 Oct 19.